Ankle tibia plates

ABSTRACT

Implant devices for the internal fixation of fractured bones, and more particularly to ankle plates for the tibia bone are disclosed and include an anterolateral tibia plate having an L-shaped body including a proximal portion defining a longitudinal axis, and a distal portion defining a traverse axis, and having a support bridge connected between the proximal portion and the distal portion. Implant devices disclosed also include an anterior tibia plate having an elongated first portion, a second portion that widens outward with respect to the elongated first portion, and a plurality of removable tabs attached to the outer edge of the second portion. Implant devices disclosed also include a medial tibia plate having an elongated shaft with a proximal portion and a distal portion. The distal portion is configured to extend proximate to a base of medial malleolus, and has a curvature with respect to a longitudinal axis defined by the elongated shaft. The distal portion may include a plurality of removable tabs. The removable tabs may be disposed to define an opening between the removable tabs to orient a bone fastener into a bone.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a division of U.S. patent application Ser.No. 14/279,225 filed May 15, 2014 and entitled “ANKLE TIBIA PLATES.” Thepresent application is also related to U.S. patent application Ser. No.______ [Attorney docket no. OSTP.P0077US.D2/11611370], filedconcurrently herewith. The disclosures of both applications areincorporated by reference herein in their entirety.

TECHNICAL FIELD

The present application relates to implant devices for the internalfixation of fractured bones, and more particularly to ankle platesdisposed on the tibia.

BACKGROUND

A fractured or broken ankle can include a break or fracture of the tibiabone. Fractures or breaks of the tibia bone are often repaired byholding bone fragments together to achieve fusion. Generally, this isaccomplished by the use of ankle plates that are attached directly tothe outer surface of the bone via a surgical procedure.

As with any other bone fracture, the structural strength of a plate usedto repair an ankle fracture is of paramount importance. Strength of aplate is generally proportional to the thickness of the plate. However,a thick plate often causes discomfort to the patient since is attacheddirectly to the outer surface of the bone under the skin. A thin plate,while possibly being more comfortable for the patient, reduces thestructural strength of the plate, thus making it weaker. A weaker ankleplate is more likely to fail under the stress of patient activity, andtherefore exposes the patient to serious injury.

The current state of the art favors a “one size fits all” solution forankle plates. Thus, where a particular ankle plate might not fit aparticular patient, a surgeon wishing to modify the ankle plate to fitit to the patient will typically have to bend, shape, cut, thin out, orotherwise manipulate the ankle plate so that it fits the patient. Suchmodifications to the ankle plate, however, result in a reduction in thestructural strength of the ankle plate.

Accordingly, a need exists for an ankle plate that can provide highstructural strength, while at the same time providing more options forcustomization, and reducing discomfort to the patient.

BRIEF SUMMARY

The present application describes various embodiments of an implantdevice for fusing bones of a fractured tibia. In accordance with one ormore embodiments of the present disclosure, an ankle plate may includean L-shaped body. The L-shaped body may include a proximal portiondefining a longitudinal axis and a distal portion defining a traverseaxis. The L-shaped body may also include a plurality of apertures. Eachof the plurality of apertures of the elongated body may be disposed in amanner so as to receive and orient a respective bone fastener in apredetermined direction. In some embodiments of the present disclosure,the apertures may be non-threaded, threaded, or a combination thereof.

In some embodiments, the proximal portion of the L-shaped body may havea first thickness that may be determined by one or more factors such asthe size of the tibia, required strength, or other patient-specificrequirements. The distal portion of the L-shaped body may have a secondthickness that may be determined by a number of factors such as the sizeof the tibia, required strength, or other patient-specific requirements.In some embodiments of the present disclosure, the distal portion'sthickness may be the same as the proximal portion's thickness.Alternatively, the distal portion's thickness may be less than theproximal portion's thickness. Further, the thickness of the L-shapedbody may transition from a first thickness of the proximal portion intoa second thickness of the distal portion along the longitudinal axis ofthe proximal portion. In some embodiments of the present disclosure, thetransition from the proximal portion's thickness into the distalportion's thickness may be a tapering of the thickness, or it may not betapered. The distal portion of the L-shaped body may be configured toconform to a distal portion of a tibia bone. For example, the distalportion may include a preformed arc configured to curve with respect tothe traverse axis.

The ankle plate according to one or more embodiments of the presentdisclosure may also include a support bridge. The support bridge may beconnected or span between the proximal portion and the distal portion ofthe L-shaped body. The support bridge may also include a plurality ofapertures. Each of the plurality of apertures of the support bridge maybe disposed to orient a respective bone fastener into a bone. In someembodiments of the present disclosure, the apertures may benon-threaded, threaded, or a combination thereof. The support bridge maybe disposed to provide additional structural support for the ankleplate. Additionally or alternatively, the support bridge may be disposedto provide additional fixation points for the ankle plate. By providingadditional structural support and additional fixation points for theankle plate, the support bridge enables portions of the L-shaped body tobe thinned out, while maintaining a high level of overall structuralstrength for the ankle plate. For example, the thickness of the distalportion may be reduced significantly, thereby lessening the discomfortto the patient, and the loss of structural strength of the ankle platecaused by the thinning of the distal portion may be offset by the gainin structural strength provided by the support bridge.

In accordance with another embodiment of the present disclosure, anankle plate may include an elongated first portion, and a second portionthat may be triangularly shaped and may widen outward with respect tothe elongated portion. The elongated first portion and the secondportion may include a plurality of apertures. Each of the plurality ofapertures of the elongated first portion may be disposed in a manner soas to receive and orient a respective bone fastener in a predetermineddirection. In some embodiments of the present disclosure, the aperturesmay be non-threaded, threaded, or a combination thereof. The elongatedfirst portion may have a first thickness that may be determined by anumber of factors such as the size of the tibia, required strength, orother patient-specific requirements. Additionally, or alternatively, thesecond portion may have a thickness that may be determined by a numberof factors such as the size of the tibia, required strength, or otherpatient-specific requirements. In some embodiments of the presentdisclosure, the second portion's thickness may be the same as theelongated first portion's thickness. In some embodiments of the presentdisclosure, the second portion's thickness may be less than theelongated first portion's thickness. The thickness of the elongatedfirst portion may transition into the thickness of the second portion ata point proximate to the point where the elongated first portiontransitions into the second portion, or at any point along the elongatedfirst portion, or along the second portion. In some embodiments of thepresent disclosure, the transition from the thickness of the elongatedfirst portion into the thickness of the second portion may be a taperingof the thickness, or it may not be tapered. Additionally, in someembodiments, the second portion may be configured to conform to a distalportion of a tibia bone.

The ankle plate according to one or more embodiments of the presentdisclosure may also include a plurality of removable tabs that may beattached to the second portion along the outer edge of the secondportion. The removable tabs may be configured to be completely removedfrom the ankle plate, or may be configured to be flexible and bendable,allowing them to be bent and wrapped around the distal portion of theanterior surface of the tibia bone in order to customize the loadbearing support of the ankle plate. The removable tabs may provideadditional fixation points for the ankle plate. The additional fixationpoints provided by the removable tabs may include at least one aperturedisposed in a manner so as to receive and orient a respective bonefastener in a predetermined direction.

Additionally, or alternatively, in some embodiments of the presentdisclosure, the second portion may include a central opening. Thecentral opening may follow the contour of the outer edge of the secondportion, and may include a middle bridge disposed within the centralopening. Additionally, the middle bridge may be configured to provideadditional fixation points for the ankle plate. The additional fixationpoints provided by the middle bridge may include at least one aperturedisposed in a manner so as to receive and orient a respective bonefastener in a predetermined direction. Further, the middle bridge mayprovide additional structural strength to the ankle plate such that thethickness of the elongated first portion and the thickness of the secondportion of the ankle plate may be reduced without reducing the overallstructural strength of the ankle plate.

In another embodiment, an ankle plate may include an elongated shaft.The elongated shaft may define a longitudinal axis and may have aproximal portion and a distal portion. The elongated shaft may include aplurality of apertures. Each of the plurality of apertures of theelongated shaft may be disposed to orient a respective bone fastenerinto a bone. The apertures may be non-threaded, threaded, or acombination thereof. In some embodiments, at least one aperture may bean elongate compression slot. In some embodiments of the presentdisclosure, the distal portion may be configured to extend proximate toa base of a medial malleolus portion of the tibia. Additionally, oralternatively, the distal portion may have a curvature with respect tothe longitudinal axis, and may be configured to conform to a the medialmalleolus portion of the distal medial surface of the tibia bone. Theproximal portion may have a first thickness and the distal portion mayhave a second thickness. The thickness of the proximal portion and thethickness of the distal portion may be determined by a number of factorssuch as the size of the tibia, required strength, or otherpatient-specific requirements. In some embodiments, the distal portion'sthickness may be less than the proximal portion's thickness. Thethickness of the proximal portion may transition into the thickness ofthe distal portion at a point proximate to the point where the proximalportion transitions into the distal portion, or at any point along theproximal portion, or along the distal portion. In some embodiments, thetransition from the proximal portion's thickness into the distalportion's thickness may be a tapering of the thickness, or it may not betapered.

Additionally, in one embodiment, the distal portion of the elongatedshaft may include a plurality of removable tabs. Each tab in theplurality of removable tabs may have an aperture disposed in a manner soas to receive and orient a respective bone fastener in a predetermineddirection. The apertures may be non-threaded, threaded, or a combinationthereof. In some embodiments, the removable tabs may be disposed todefine an opening, between the removable tabs. This opening may beutilized as an aperture configured to receive and orient a bone fastenerin a predetermined direction into the bone. I will be appreciated thatthe angles of orientation of the opening aperture may vary according tothe requirements of the ankle plate. In some embodiments, the angle oforientation of the opening aperture may be different than the angle oforientation of the tab aperture.

The foregoing has outlined rather broadly the features and technicaladvantages of the present invention in order that the detaileddescription that follows may be better understood. Additional featuresand advantages will be described hereinafter which form the subject ofthe claims. It should be appreciated by those skilled in the art thatthe conception and specific embodiment disclosed may be readily utilizedas a basis for modifying or designing other structures for carrying outthe same purposes of the present application. It should also be realizedby those skilled in the art that such equivalent constructions do notdepart from the spirit and scope of the application as set forth in theappended claims. The novel features which are believed to becharacteristic of embodiments described herein, both as to itsorganization and method of operation, together with further objects andadvantages will be better understood from the following description whenconsidered in connection with the accompanying figures. It is to beexpressly understood, however, that each of the figures is provided forthe purpose of illustration and description only and is not intended asa definition of the limits of the present embodiments

BRIEF DESCRIPTION OF THE DRAWINGS

For a more complete understanding, reference is now made to thefollowing descriptions taken in conjunction with the accompanyingdrawings, in which:

FIG. 1A illustrates an example embodiment of an anterolateral ankleplate;

FIGS. 1B and 1C illustrate an example embodiment of an anterolateralankle plate attached to the anterior lateral surface of a tibia bone.

FIG. 2A illustrates an example embodiment of an anterior ankle plate;

FIGS. 2B-2D illustrate an example embodiment of an anterior ankle plateattached to the anterior surface of a tibia bone;

FIGS. 3A and 3B illustrate an example embodiment of a medial ankleplate; and

FIG. 3C illustrate an example embodiment of a medial ankle plateattached to the medial surface of a tibia bone.

DETAILED DESCRIPTION

The detailed description set forth below, in connection with theappended drawings, is intended as a description of variousconfigurations and is not intended to limit the scope of the disclosure.Rather, the detailed description includes specific details for thepurpose of providing a thorough understanding of the inventive subjectmatter. It will be apparent to those skilled in the art that thesespecific details are not required in every case and that, in someinstances, well-known structures and components are shown in blockdiagram form for clarity of presentation. Likewise, the terminology usedherein is for the purpose of describing particular embodiments only, andis not intended to limit the invention

Referring to FIG. 1A, an illustrative embodiment of an ankle plate forattaching to the anterior lateral surface of a tibia bone is shown anddesignated 100. FIG. 1B shows a representative example of ankle plate100 attached to tibia bone 120. In the illustrated embodiments, ankleplate 100 includes a proximal portion 102 with a longitudinal axis 105,a distal portion 103 with a traverse axis 106, and a support bridge 104.

Proximal portion 102 and distal portion 103 may also be provided with aplurality of apertures 107. The number of apertures 107 in proximalportion 102 and distal portion 103 may generally be dictated by thelength of proximal portion 102 and distal portion 103, which may varydepending on the length of tibia bone, the length of the bone fracturebeing treated, the stability required, or any factors needed to provideefficient fixation strength for the ankle plate. Each aperture 107 maybe a threaded aperture or a non-threaded aperture. In some embodiments,some apertures 107 may be threaded while other apertures 107 may benon-threaded. Generally, threaded apertures provide for fixation ofankle plate 100 to tibia bone 120 by use of fixation screws. Theapertures 107 may even alternate between threaded and non-threaded,depending on the requirements of the ankle plate. As shown in FIG. 1C,apertures 107 of proximal portion 102 and distal portion 103 may bedisposed to receive and orient a bone fastener 130 into the tibia bone.The bone fastener may be a bolt, screw, wire, or any other fasteneradapted to secure the ankle plate to the tibia bone. Proximal portion102 and distal portion 103 may also include temporary guide pin holes115. In some embodiments, temporary guide pin holes 115 may be adaptedto receive and orient a temporary pin that may be used to temporarilyhold ankle plate 100 in place while it is being installed on tibia bone120.

As shown in FIG. 1A, proximal portion 102 may be twisted aboutlongitudinal axis 105 in order to match the anterior lateral bonesurface of the tibia. The degree of the twist may be determined by anynumber of factors, including the geometry of the tibia bone, thefracture being treated, the particular position of the ankle plate onthe tibia, and the like. Proximal portion 102 may have a particularlength, which may vary depending on the length of tibia bone, the lengthof the fracture being treated, the stability required, or any factorsneeded to provide efficient fixation strength for ankle plate 100. Ascan be seen in FIG. 1A, one end of proximal portion 102 may transitioninto distal portion 103.

Proximal portion 102 may have a bottom surface 109, and a top surface110, where the top surface 110 is the surface opposite to bottom surface109. In this manner, proximal portion 102 may define a thickness 111which may be the distance between bottom surface 109 and top surface110. Thickness 111 of proximal portion 102 may be constant over thelength of proximal portion 102, or may vary over the length. In someembodiments, the variance of thickness 111 over the length of proximalportion 102 may be uniform, giving proximal portion 102 a tapered shape.Alternatively, thickness 111 may vary non-uniformly over the length ofproximal portion 102 in order to conform to a particular shape, or tomeet specific patient requirements. In some embodiments, thickness 111of proximal portion 102 may be constant over the majority of the lengthof proximal portion 102 but then begin to vary at the point whereproximal portion 102 transitions into distal portion 103. As illustratedin the embodiment of FIG. 1A, thickness 111 begins to vary alonglongitudinal axis 105 after the fifth aperture 107, and transitions froma first thickness 111 to a second thickness 114.

As further shown in FIG. 1A, a distal portion 103 may be provideddefining a traverse axis. As shown in FIG. 1C, distal portion 102 mayhave an arc with respect to axis 106 to match the distal surface ofanterior lateral surface 121 of tibia bone 120. The degree of the arc ofdistal portion 103 may be determined by any number of factors, includingthe geometry of the tibia bone, the fracture being treated, or theparticular position of the ankle plate on tibia bone 120.

Distal portion 103 may have a top surface 112, and a bottom surface 113,where the top surface 112 is the surface opposite to bottom surface 113.In this manner, distal portion 103 may define a thickness 114, which maybe the distance between bottom surface 113 and top surface 112.Thickness 114 of distal portion 103 may be constant over the wholelength of distal portion 103, or may vary over the length. In someembodiments, the variance of thickness 114 over the length of distalportion 103 may be uniform, giving distal portion 103 a tapered shape.Alternatively, thickness 114 may vary non-uniformly over the length ofdistal portion 103 in order to conform to a particular shape of thedistal surface, or to meet specific patient requirements. In someembodiments, thickness 114 of distal portion 103 may be constant overthe majority of the length of distal portion 103 but vary at the pointwhere proximal portion 102 transitions into distal portion 103, therebytapering the transition between proximal portion 102 and distal portion103.

In some embodiments of ankle plate 100, thickness 114 of distal portion103 may be less than thickness 111 of proximal portion 102 in order toaccommodate the geometry of anterior lateral portion 121 of tibia bone120. It should be appreciated that the distal surface of anteriorlateral portion 121 may be more prominent under the skin than the restof anterior lateral surface 121. Accordingly, it may be more desirableto adapt distal portion 103 to have a thickness 114 that is less thanthickness 111 of proximal portion 102, in order that ankle plate 100 maynot be overly prominent under the skin. In some embodiments, thickness111 is not constant over the length of proximal portion 102. As can beseen in FIG. 1A, thickness 111 of proximal portion 102 is less at apoint proximate to distal portion 103 than at a point at the other endof proximal portion 102. In the illustrated embodiment, thickness 111begins to decrease at the point where support bridge 104 connects toproximal portion 102, and transitions into thickness 114. In this case,thickness 111 at the point proximate to distal portion 103 may be thesame as thickness 114, but may be greater at the point at the other endof proximal portion 102.

It should be appreciated that thickness 111 of proximal portion 102,along with thickness 114 of distal portion 103, may contribute to theoverall structural strength of ankle plate 100. Ankle plate structuralstrength is important because an ankle plate according to embodiments ofthe present invention may be used to hold pieces of tibia bone 120together, or even the tibia bone to another bone, in order to stabilizethe bone, keep the pieces of bone in alignment next to one another, andthereby enabling the bone fracture to heal. A thicker ankle plate 100may provide greater structural strength than would a thinner ankle plate100, and thereby provide better stabilization. However, since ankleplate 100 may be designed to be attached to the anterior lateral surfaceof a tibia under the skin, a thicker plate may cause more discomfort tothe patient than would a thinner plate. Therefore, embodiments maybalance the thickness of an ankle plate with the structural strengthrequirements of the patient in order to design an ankle plate that willcause the least discomfort to the patient while maintaining anappropriate level of structural strength.

As shown in FIG. 1A, ankle plate 100 may include a support bridge 104.Support bridge 104 may be connected between proximal portion 102 anddistal portion 103, and may be adapted to provide additional structuralsupport to ankle plate 100. By providing additional structural supportto ankle plate 100, support bridge 104 enables proximal portion 102 anddistal portion 103 to be thinned, while maintaining a high level ofoverall structural strength of ankle plate 100. For example, thickness114 of distal portion 103 may be reduced significantly, therebylessening the discomfort to the patient, and the loss of structuralstrength of ankle plate 100 caused by the thinning of distal portion 103may be offset by the gain in structural strength provided by supportbridge 104.

In some embodiments, support bridge 104 may be connected betweenproximal portion 102 and distal portion 103 at any point along proximalportion 102 and distal portion 103, according to desired structuralparameters. The length of support bridge 104 is determined by thedistance between the points on proximal portion 102 and distal portion103 to which support bridge 104 is connected. It is appreciated that alonger support bridge 104 may provide more structural support than ashorter support bridge 104 would. Therefore, the length of supportbridge 104 may be selected according to structural strengthrequirements. For example, thickness 114 of distal portion 103 may bereduced slightly, thereby requiring a relatively short support bridge104. Alternatively, thickness 114 of distal portion 103 may be reducedfurther, thereby requiring a longer support bridge 104 to offset theloss of structural strength of ankle plate 100.

Support bridge 104 may have a thickness, which can vary according todesired structural parameters. It is appreciated that a thicker supportbridge 104 may provide more structural support than a thinner supportbridge 104 would. Therefore, the thickness of support bridge 104 may beselected according to structural strength requirements. For example,thickness 114 of distal portion 103 may be reduced slightly, therebyrequiring a relatively thin support bridge 104. Alternatively, thickness114 of distal portion 103 may be reduced further, thereby requiring athicker support bridge 104 to offset the loss of structural strength ofankle plate 100. As shown in FIG. 1A, proximal portion 102 has firstthickness, distal portion 103 has second thickness, and support bridge104 has second thickness, although in some embodiments, support bridgemay have third thickness. As can be seen, the thickness of supportbridge may be less than the thickness of proximal portion 102 at thepoint where support bridge 104 adjoins proximal portion 102.

One of ordinary skill in the art will appreciate that a loss ofstructural strength of ankle plate 100 due to a reduction of thickness111 of proximal portion 102, or thickness 114 of distal portion 103, maybe offset by either increasing the length or thickness of support bridge104, or both.

In some embodiments, support bridge 104 may also be adapted to provideadditional fixation points for ankle plate 100. As can be seen in FIGS.1A and 1B, support bridge 104 is provided with apertures 108. Apertures108 of support bridge 107 may be adapted to orient a bone fastener intothe tibia bone. Ankle plate 100 may be configured so that when ankleplate 100 is attached to the anterior lateral portion of tibia bone 120,support bridge 104 may contact the anterior portion of tibia bone 120.By providing additional fixation points, support bridge 104 provides anincrease in stabilization of the fracture area, and may allow insertionof screws that may be used to hold pieces of the fractured tibia bone120 together.

The number of apertures 108 in the support bridge 104 may generally bedictated by the length of support bridge 104. Each aperture 108 may be athreaded aperture or a non-threaded aperture. In some embodiments, someapertures 108 may be threaded while other apertures 108 may benon-threaded. The apertures 108 may even alternate between threaded andnon-threaded, depending on the requirements of the ankle plate. Theapertures 108 of support bridge 104 may serve to orient a bone fastenerinto the tibia bone. The bone fastener may be a bolt, screw, wire, orany other fastener adapted to secure the ankle plate to the tibia bonebefore, during, or after implantation of ankle plate 100.

In some embodiments, support bridge 104 may be a component separate fromproximal portion 102 and distal portion 103 that can be connected toproximal portion 102 and distal portion 103. In that case, supportbridge 104 may include a mechanism for connecting between proximalportion 102 and distal portion 103. In other embodiments, support bridge104 is manufactured as part of proximal portion 102 and distal portion103, and not as a separate component. In that case, there may be no needto provide a connection mechanism, since support bridge 104, proximalportion 102, and distal portion 103 may be part of a single piece. Insome embodiments, support bridge 104 may be removable when theadditional support is not needed.

FIGS. 1B and 1C illustrate ankle plate 100 being used on ankle 120. Ascan be seen in FIG. 1B, ankle plate 100 may be adapted to conform toanterior lateral surface 121 of tibia bone 120. In some embodiments,proximal portion 102 of ankle plate 100 may be adapted to conform toanterior lateral surface 121 of tibia bone 120. In some embodiments,proximal portion 102 may be twisted about longitudinal axis 105 in orderto match the contour of anterior lateral surface 121. As will beappreciated, the degree of twist may be determined by the contour ofanterior lateral surface 121. In some embodiments, distal portion 103may be adapted to conform to the distal surface of anterior lateralsurface 121 of tibia bone 120. FIG. 1C shows in greater detail distalportion 130 being adapted to conform to the contour of the distalsurface of anterior lateral surface 121. In some embodiments, distalportion may have an arc following the contour of the distal surface ofanterior lateral surface 121 portion of tibia bone 120. The degree ofthe arc of distal portion 103 may be determined by any number offactors, including the geometry of the tibia bone, the fracture beingtreated, the particular position of the ankle plate on tibia bone 120,etc.

Referring to FIG. 2A, an illustrative embodiment of an ankle plate forattaching to the anterior portion of a tibia bone is shown anddesignated 200. FIGS. 2B-2C show examples of different configurations ofankle plate 200 attached to tibia bone 120. Referring back to FIG. 2A,in some embodiments, ankle plate 200 may include an elongated firstportion 201, a second portion 202, and a removable tabs 203. In someembodiments of ankle plate 200, a middle bridge 204 is provided withincentral opening 212. Ankle plate 200 may also include temporary guidepin holes 213. In some embodiments, temporary guide pin holes 213 may beadapted to receive and orient a temporary pin that may be used totemporarily hold ankle plate 200 in place while it is being installed ontibia bone 120.

Elongated first portion 201 may have a particular length, which may varydepending on the length of tibia bone, the length of the fracture beingtreated, the required stability of ankle plate 200, or any factorsneeded to provide efficient fixation strength for ankle plate 200. Asshown in FIG. 2B, in some embodiments, elongated first portion 201 maydefine a longitudinal axis, and be twisted about the longitudinal axisin order to match the contour of anterior surface 122. As will beappreciated, the degree of twist may be determined by the contour ofanterior surface 122.

Elongated first portion 201 may be provided with a plurality ofapertures 205. The number of apertures 205 of elongated portion 201 maygenerally be dictated by the length of elongated portion 201, which mayvary depending on the length of tibia bone, the length of the fracturebeing treated, the stability required, or any factors needed to provideefficient fixation strength for the ankle plate. Each aperture 205 maybe a threaded aperture or a non-threaded aperture. In some embodiments,some apertures 205 may be threaded while other apertures 205 may benon-threaded. The apertures 205 may even alternate between threaded andnon-threaded, depending on the requirements of the ankle plate.Apertures 205 may serve to orient a bone fastener into the tibia bone.The bone fastener may be a bolt, screw, wire, or any other fasteneradapted to secure the ankle plate to the tibia bone before, during, orafter implantation of ankle plate 200.

Elongated first portion 201 may have a top surface 209, and a bottomsurface (not shown), where the top surface 209 is the surface oppositeto the bottom surface. In this manner, elongated first portion 201 maydefine a first portion thickness which may be the distance between thebottom surface and top surface 209. The first portion thickness may beconstant over the whole length of elongated first portion 201, or mayvary over the length. In some embodiments, the variance of the firstportion thickness over the length of elongated first portion 201 may beuniform, giving elongated first portion 201 a tapered shape.Alternatively, the first portion thickness may vary non-uniformly overthe length of elongated first portion 201 in order to conform to aparticular shape, or to meet specific patient requirements. In someembodiments, the first portion thickness of elongated first portion 201may be constant over the majority of the length of elongated firstportion 201 but then vary at the point where elongated first portion 201transitions into second portion 202. Further, the first portionthickness may vary within the second portion. For example, as can beseen in FIG. 2A, approximately 20%-50% of ankle plate 200, whichincludes the whole length of elongated first portion 201 and part ofsecond portion 202 may have a thickness T1, which transitions intothickness T2 in the lower portion of ankle plate 200.

As shown in FIGS. 2A-2D, second portion 202 may be triangularly shaped,widening outward with respect to elongated portion 201. Second portion202 may also be adapted to conform to anterior surface 122. For example,second portion 202 may be configured to have a curvature in order toconform to the contour of the distal surface of anterior surface 122 oftibia bone 120. The degree of the curvature of second portion 202 may bedetermined by any number of factors, including the geometry of the tibiabone, the fracture being treated, or the particular position of theankle plate on tibia bone 120.

Second portion 202 may be provided with a plurality of apertures 206.The number of apertures 206 of second portion 202 may generally bedictated by the length and width of second portion 202, which may varydepending on the length of tibia bone, the length of the fracture beingtreated, the stability required, or any factors needed to provideefficient fixation strength for the ankle plate. Each aperture 206 maybe a threaded aperture or a non-threaded aperture. In some embodiments,some apertures 206 may be threaded while other apertures 206 may benon-threaded. The apertures 206 may even alternate between threaded andnon-threaded, depending on the requirements of the ankle plate.Apertures 206 may serve to orient a bone fastener into the tibia bone.The bone fastener may be a bolt, screw, wire, or any other fasteneradapted to secure the ankle plate to the tibia bone before, during, orafter implantation of ankle plate 200.

Second portion 202 may have a top surface 210, and a bottom surface (notshown), where the top surface 210 is the surface opposite to the bottomsurface. In this manner, second portion 202 may define a second portionthickness which may be the distance between the bottom surface and topsurface 210. The second portion thickness may be constant over the wholelength of second portion 202, or may vary over the length. In someembodiments, the variance of the second portion thickness over thelength of second portion 202 may be uniform, giving second portion 202 atapered shape. Alternatively, the second portion thickness may varynon-uniformly over the length of second portion 202 in order to conformto a particular shape, or to meet specific patient requirements. In someembodiments, the second portion thickness of second portion 202 may beconstant over the majority of the length of second portion 202 but thenvary at the point where elongated first portion 201 transitions intosecond portion 202.

In some embodiments of ankle plate 200, the thickness of second portion202 may be less than the thickness of elongated first portion 201 inorder to accommodate the geometry of anterior portion 122 of tibia bone120. It should be appreciated that the distal surface of anteriorportion 122 may be more prominent under the skin than the rest ofanterior surface 122. Accordingly, it may be more desirable to adaptsecond portion 202 to have a second portion thickness that is less thanthe first portion thickness of elongated first portion 201, in orderthat ankle plate 200 may not be overly prominent under the skin.

It should be appreciated that first portion thickness of first portion201, along with second portion thickness of second portion 202, maycontribute to the overall structural strength of ankle plate 200. Ankleplate structural strength is important because an ankle plate accordingto embodiments of the present invention may be used to hold pieces oftibia bone 120 together, or even the tibia bone to another bone, inorder to stabilize the bone, keep the pieces of bone in alignment nextto one another, and thereby enabling the bone fracture to heal. Athicker ankle plate 200 may provide greater structural strength thanwould a thinner ankle plate 200, and thereby provide betterstabilization. However, since ankle plate 200 may be designed to beattached to the anterior surface of a tibia bone under the skin, athicker plate may cause more discomfort to the patient than would athinner plate. Therefore, embodiments may balance the thickness of anankle plate with the structural strength requirements of the patient inorder to design an ankle plate that will cause the least discomfort tothe patient while maintaining an appropriate level of structuralstrength.

Second portion 202 is shown in FIG. 2A-2D including a central opening212. It should be appreciated that in some embodiments of ankle plate200, second portion 202 may not include central opening 212. Centralopening 212 may be of a particular shape, or it may follow the contourof the outer edge of second portion 202. In some embodiments, centralopening 212 of second portion 202 may be adapted to include middlebridge 204, as shown in FIG. 2A. Middle bridge 204 may be adapted toprovide additional structural support to ankle plate 200. It should beappreciated that by providing additional structural support to ankleplate 200, middle bridge 204 enables elongated first portion 201 andsecond portion 202 to be thinned, while maintaining a high level ofoverall structural strength of ankle plate 200. For example, the secondportion thickness of second portion 202 may be reduced significantly,thereby lessening the discomfort to the patient, and the loss ofstructural strength of ankle plate 200 caused by the thinning of secondportion 202 may be offset by the gain in structural strength provided bymiddle bridge 204.

The size of middle bridge 204 may be determined by the size secondportion 202, or the size of central opening 212. It is appreciated thata bigger middle bridge 204 may provide more structural support than asmaller middle bridge 204 would. Therefore, the size of middle bridge204 may be selected according to structural strength requirements. Forexample, the second portion thickness of second portion 202 may bereduced slightly, thereby requiring a relatively small middle bridge204. Alternatively, the second portion thickness of second portion 202may be reduced further, thereby requiring a bigger middle bridge 204 tooffset the loss of structural strength of ankle plate 200.

In some embodiments, middle bridge 204 may be adapted to provideadditional fixation points for ankle plate 200. As can be seen in FIGS.2A-2D, middle bridge 204 is provided with aperture 208. Aperture 208 maybe adapted to orient a bone fastener into the tibia bone. By providingadditional fixation points, support bridge 104 provides an increase instabilization of the fracture area, and may allow insertion of screwsthat may be used to hold pieces of the fractured tibia bone 120together. Although middle bridge 204 is shown as including one fixationpoint, the number of apertures 208 in middle bridge 204 may generally bedictated by the size of middle bridge 204. Aperture 208 may be athreaded aperture or a non-threaded aperture. Aperture 208 may beconfigured to orient a bone fastener into the tibia bone.

As shown in FIG. 2A, ankle plate 200 may include removable tabs 203. Ina preferred embodiment of ankle plate 200, removable tabs 203 may bering-shaped and may be attached to the outer edge of second portion 202with a bridge 211. Removable tabs 203 may be configured to be completelyremoved from ankle plate 200. Additionally, removable tabs 203 may beconfigured to be flexible and bendable at bridge 211, allowing them tobe bent and wrapped around the distal portion of the anterior surface ofthe tibia bone in order to customize the load bearing support of ankleplate 200. In the current embodiment, removable tabs 203 may bepre-formed to curve around the surface of tibia bone 120. Removable tabs203 may allow a “one-size-fits-all”, or universal, ankle plate 200 thatmay be suitable for patients with different size requirements. Forexample, where ankle plate 200 is being used for treating a patient witha relatively small tibia bone 120, removable tabs 203 may be removed, orbent and wrapped around the bone to provide fixation points for ankleplate 120. It should be appreciated by those skilled in the art, thatproviding removable tabs 203 that can bend to wrap around the tibia boneeliminates the need to bend second portion 202 to wrap around the bone.Therefore, a smaller second portion 202 can be provided with removabletabs 203 that can be either removed when not needed, or bent to wraparound the tibia bone to provide additional fixation points.

FIG. 2C, shows a configuration of ankle plate 200 where two removabletabs have been completely removed, in order to facilitate implantationof ankle plate 200. This may be the case where ankle plate 200 is beingused to treat a patient with a relatively small tibia bone.Alternatively, FIG. 2B shows a configuration of ankle plate 200 where notabs have been removed. This may be the case where ankle plate 200 isbeing used to treat a patient with a larger tibia bone. It should beappreciated that removable tabs 203 may be removed from ankle plate 200by use of specialized tools, stet generally available tools, that applya particular amount of force required to remove tabs 203 from ankleplate 200 by fracture of bridge 211, or by bending removable tabs in onedirection and then the opposite direction until a fracture of bridge 211is effected. Preferably, removal of one or more removable tabs 203 isdone in a manner so as to not have sharp, or rough edges. In someembodiments, removable tabs 203 may be adapted to facilitate theirremoval from ankle plate 200. For example, removable tabs 203 may bemade of dissimilar materials than second portion 202, or score lines maybe provided at bridge 211. Removable tabs 203 may be adapted to fracturefrom ankle plate 200 upon the application of a particular amount offorce.

FIGS. 2C and 2D show a configuration of ankle plate 200 where removabletabs 203 have been bent to wrap around anterior surface 122. In someembodiments, removable tabs 203 may be adapted to be flexible andbendable, thereby allowing a surgeon to easily bend them and wrappedthem around tibia bone 120 to conform to the contour of anterior surface122. In a preferred embodiment, bridge 211 of removable tabs 203 may beconfigured to bend in rotation around the y-axis. Thus, each bridge 211may have a rectangular cross-section, with a width greater thanthickness.

Wrapping removable tabs 203 around anterior surface 122 may provideadditional fixation point. In some embodiments, wrapping removable tabs203 around tibia bone 120 may provide additional angles for fixation ofankle plate 200. For example, by bending removable tabs 203 to aparticular angle relative to the planar surface of second portion 202, afixation point may be provided that may be adapted to orient a bonefastener into tibia bone 120 at the particular angle. To effect bending,specialized bending tools may be provided that apply force proximate tobridge 211 to effect a change in removable tabs 203 orientation.Removable tabs 203 bending may be effected while ankle plate 200 isinstalled on the bone, or may be effected while ankle plate 200 is noton the bone, prior to surgery. In some embodiments, the area ofremovable tabs 203 around the aperture 207 may be designed thicker thanbridge 211 in order to ensure that aperture 207 is not deformed.

Removable tabs 203 may be adapted to include apertures 207, which mayprovide additional fixation points for ankle plate 200. By providingadditional fixation points, removable tabs 203 may provide an increasein stabilization of the fracture area, and may allow insertion of screwsthat may be used to hold pieces of the fractured tibia bone 120together. Each aperture 207 may be implemented in a similar manner asdescribed with respect to apertures 205 and 206.

Referring to FIGS. 3A and 3B, an illustrative embodiment of an ankleplate for attaching to the medial surface of a tibia bone is shown anddesignated 300. In some embodiments, ankle plate 300 may include anelongated shaft 301, which may define a longitudinal axis 304, aproximal portion 302, and a distal portion 303. Ankle plate 300 may alsoinclude temporary guide pin holes 317. In some embodiments, temporaryguide pin holes 317 may be adapted to receive and orient a temporary pinthat may be used to temporarily hold ankle plate 300 in place while itis being installed on tibia bone 120.

As can be seen in FIG. 3C, ankle plate 300 may be adapted to conform tomedial surface 320 of tibia bone 120. In some embodiments, ankle plate300 may be configured to define a curvature with respect to longitudinalaxis 304 in order to conform to the contour of medial surface 320. Thecurvature defined by ankle plate 300 may be convex with respect tolongitudinal axis 304 along proximal portion 302, and may be concavewith respect to longitudinal axis 304 along distal portion 303. Thedegree of the convex curvature along proximal portion 302 may increasegradually along the length of proximal portion 302. In that case, thedegree of the convex curvature along proximal portion 302 at one pointin proximal portion 302 may be different than the degree of the convexcurvature at another point in proximal portion 302. Similarly, theconcave curvature along distal portion 303 may increase gradually alongthe length of distal portion 303, or may be constant. In should beappreciated that the degree of the convex curvature of proximal portion302 and the degree of the concave curvature of distal portion 303 may bedetermined by any number of factors, including the geometry of medialsurface 304 of tibia bone 120, the size of the patient being treated,the type of fracture being treated, the particular position of the ankleplate on tibia bone 120, etc.

In some embodiments, the concave curvature along distal portion 303 maybe pre-configured to conform to medial malleolus 321. One of ordinaryskill in the art will appreciate that the medial malleolus refers to theprominent area of the medial side of tibia bone 120, formed by the lowerend of tibia bone 120. Accordingly, in some embodiments, distal portion303 may be provided having a concave curvature in order to match thecontour of medial malleolus 321. The concave curvature of distal portion303 may be effected during manufacture of ankle plate 300, aftermanufacture but before surgery, or during surgery before implantation.It should be appreciated that where the convex curvature is effectedafter manufacture, the structural strength of ankle plate 300 may bereduced due to the curvature. Thus, the pre-curve of ankle plateprevents, or lessens, any weakening that would result fromafter-manufacturing bending. In some embodiments of the presentinvention, ankle plate 300 may be provided configured to have sufficientstrength such that any weakening experienced from after-manufacturebending will still result in an ankle plate with acceptable strength forimplantation.

Referring to FIG. 3B, proximal portion 302 may have a top surface 310,and a bottom surface 311, where top surface 310 is the surface oppositeto bottom surface 311. In this manner, proximal portion 302 may define athickness 312, which may be the distance between bottom surface 311 andtop surface 310. Thickness 312 of proximal portion 302 may be constantover the whole length of proximal portion 302, or may vary over thelength. In some embodiments, the variance of thickness 312 may beuniform, giving proximal portion 302 a tapered shape. Alternatively,thickness 312 may vary non-uniformly over the length of proximal portion302 in order to conform to a particular shape of medial surface 320, tomeet specific patient requirements, etc. In some embodiments, thickness312 may be constant over the majority of the length of proximal portion302 but vary at the point where proximal portion 302 transitions intodistal portion 303, thereby tapering the transition between proximalportion 302 and distal portion 303.

The length of distal portion 303 may extend from the distal tip ofmedial malleolus 321 to diaphyseal-metaphyseal junction 322 of thedistal tibia. This allows the apertures of distal portion 303 to bealigned with metaphyseal area 323 for fixation of ankle plate 300.Proximal portion 302 may extend from metaphyseal-diaphyseal junction 322proximally along diaphyseal area 324 of the tibia bone 120. The lengthof distal proximal portion 302 may vary depending factors which mayinclude the geometry of the fracture being treated, including size andshape. In some embodiments, the length of proximal portion 302 may bedetermined such that there are at least three apertures 305 between theproximal end of the fracture being treated and proximal end 325 ofproximal portion 302. In some embodiments, the length of proximalportion 302 may span the whole length of diaphyseal area 324 of medialsurface 320 of tibia 120.

Proximal portion 302 may be provided with a plurality of apertures 305and 306. The number of apertures 305 and 306 may generally be dictatedby the length of proximal portion 302, which may vary depending on thelength of tibia bone 120, the length of the fracture being treated, thestability required, or any factors needed to provide efficient fixationstrength for the ankle plate. Each aperture 305 and 306 may be athreaded aperture or a non-threaded aperture. In some embodiments,non-threaded apertures may include elongate compression slots 306 for,and/or threaded apertures 305. In some embodiments, some apertures maybe threaded apertures while other apertures may be non-threaded.Apertures 305 and 306 may even alternate between threaded andnon-threaded, depending on the requirements of the ankle plate.Apertures 305 and 306 may be adapted to orient a bone fastener intotibia bone 120.

As shown in FIG. 3B, distal portion 303 may have a top surface 313, anda bottom surface 314, where top surface 313 is the surface opposite tobottom surface 314. In this manner, distal portion 303 may define athickness 315, which may be the distance between bottom surface 314 andtop surface 313. Thickness 315 may be constant over the whole length ofdistal portion 303, or may vary over the length. In some embodiments,the variance of thickness 315 may be uniform, giving distal portion 303a tapered shape. Alternatively, thickness 315 may vary non-uniformlyover the length of distal portion 303 in order to conform to aparticular shape of medial surface 320, to meet specific patientrequirements, etc. In some embodiments, thickness 315 may be constantover the majority of the length of distal portion 303 but vary at thepoint where proximal portion 302 transitions into distal portion 303,thereby tapering the transition between proximal portion 302 and distalportion 303.

In some embodiments of ankle plate 300, thickness 315 of distal portion303 may be less than thickness 311 of proximal portion 302 in order toaccommodate the geometry of medial surface 320 of tibia bone 120. Itshould be appreciated that medial malleolus 321 of medial surface 320may be more prominent under the skin than the rest of medial surface320. Accordingly, it may be more desirable to adapt distal portion 303to have a thickness 315 that is less than thickness 311 of proximalportion 302, so that ankle plate 300 may not be overly prominent underthe skin.

As shown in FIG. 3A, distal portion 303 may be configured to include aplurality of apertures 305 and 306. The number of apertures 305 and 306may generally be dictated by the length of distal portion 303, which mayvary depending on the length of tibia bone 120, the length of thefracture being treated, the stability required, or any factors needed toprovide efficient fixation strength for the ankle plate. Each aperture305 and 306 may be a threaded aperture or a non-threaded aperture. Insome embodiments, non-threaded apertures may include elongatecompression slots 306 for compression screws (not shown), and/orthreaded apertures 305. In some embodiments, some apertures may bethreaded apertures while other apertures may be non-threaded. Apertures305 and 306 may even alternate between threaded and non-threaded,depending on the requirements of the ankle plate. In some embodiments,such as the one shown in FIGS. 3A and 3B, apertures 305 and 306, may bealigned to define two rows of apertures. The first and second rows maybe approximately parallel and apertures of the second row may bestaggered (transverse to longitudinal axis 304) with respect toapertures 305 of the first row. Apertures 305 and 306 may be adapted toorient a bone fastener into tibia bone 120. The bone fastener may be abolt, screw, wire, or any other fastener adapted to secure the ankleplate to the tibia bone before, during, or after implantation of ankleplate 300.

Distal portion 303 may include removable tabs 307. In a preferredembodiment of ankle plate 300, removable tabs 307 may be ring-shaped andmay be attached to the one end distal portion 303 with a bridge 316. Insome embodiments of ankle plate 300, removable tabs 307 define one endof distal portion 303. Removable tabs 307 may be configured to becompletely removed from ankle plate 300, or may be configured to beflexible and bendable at bridge 316 to extend under the base, or pointproximate to the distal portion of medial malleolus 321 (as seen in FIG.3C), in order to customize the load bearing support of ankle plate 300.

Removable tabs 307 may be removed from ankle plate 300 by use ofspecialized tools, stet generally available tools, that apply aparticular amount of force required to remove tabs 307 from ankle plate300 by fracture of bridge 316, or by bending removable tabs 307 in onedirection and then the opposite direction until a fracture of bridge 316is effected. Preferably, removal of one or more removable tabs 307 isdone in a manner so as to not have sharp, or rough edges. In someembodiments, removable tabs 307 may be adapted to facilitate theirremoval from ankle plate 300. For example, removable tabs 307 may bemade of dissimilar materials than the rest of distal portion 303, orscore lines may be provided at bridge 316. Removable tabs 307 may beadapted to fracture from ankle plate 300 upon the application of aparticular amount of force.

In some embodiments, removable tabs 307 may be adapted to be bendable,thereby allowing a surgeon to easily bend them and wrapped them aroundthe base of medial malleolus 321 to conform to the contour of medialmalleolus 321. To effect bending, specialized bending tools may beprovided that apply force proximate to bridge 316 to effect a change inthe orientation of removable tabs 307. In some embodiments, the area ofremovable tabs 307 around aperture 308 may be designed thicker thanbridge 316 in order to ensure that aperture 308 is not deformed whenbending is effected

Bending removable tabs 307 to extend under the base of medial malleolus321, may provide additional angles for fixation of ankle plate 300. Forexample, by bending removable tabs 307 to a particular angle relative tothe planar surface of distal portion 303, a fixation point may beprovided that may be adapted to orient a bone fastener into tibia bone120 at the particular angle. In some embodiments, this angle may be anacute angle with respect to longitudinal axis 304. Being configured toorient a bone fastener into tibia bone 120 at a particular angle,removable tabs 307 may be used to insert a transfixation screw into thebone fracture.

Removable tabs 203 may be adapted to include apertures 308, which mayprovide additional fixation points for ankle plate 300. By providingadditional fixation points, removable tabs 203 may provide an increasein stabilization of the fracture area, and may allow insertion of screwsthat may be used to hold pieces of the fractured tibia bone 120together. Each aperture 207 may be a threaded aperture or a non-threadedaperture. Apertures 207 may be adapted to orient a bone fastener intothe tibia bone. The bone fastener may be a bolt, screw, wire, or anyother fastener adapted to secure the ankle plate to the tibia bone

As can be seen in FIG. 3A, removable tabs 307 may be configured todefine opening 309 between each removable tab 307. Opening 309 may beadapted to provide additional fixation point for ankle plate 300. Insome embodiments, removable tabs 309 may be designed in such a way sothat the space between bridges 316 define an opening 309 that may beadapted to orient a bone fastener into tibia bone 120. Opening 309 maybe configured to be a threaded opening or a non-threaded opening. Insome embodiments, opening 309 may be adapted to be used when removabletabs 307 are removed.

One or more of the implant devices, or a component thereof, describedwith reference to FIGS. 1-11 may be formed using metals (e.g.,titanium), polymers, ceramics, glasses, composite materials, biologicalmaterials or tissues, insulators, conductors, semiconductors, or otherbiocompatible or non-biocompatible materials. Different materials may beused for individual components. Different materials may be combined in asingle component. In some embodiments, the implant device body may beformed using polyetheretherketone (PEEK), either alone or in combinationwith other materials. Using PEEK to form the implant device may bebeneficial because it approximates a modulus strength of bone. Ascompressive forces are applied to the bone by the PEEK implant device(or the pressure and friction forces generated by the screws), the bonestructures and various tissues and cells react, creating more bonystructure. Additionally, using PEEK implant devices may cause bone graftshoots to take more load faster than with titanium implant devices(i.e., because the titanium implant device does not compress the bonesas efficiently as the PEEK implant device).

It should be understood that the present system, kits, apparatuses, andmethods are not intended to be limited to the particular formsdisclosed. Rather, they are to cover all combinations, modifications,equivalents, and alternatives falling within the scope of the claims.

The claims are not to be interpreted as including means-plus- orstep-plus-function limitations, unless such a limitation is explicitlyrecited in a given claim using the phrase(s) “means for” or “step for,”respectively.

The use of the word “a” or “an” when used in conjunction with the term“comprising” in the claims and/or the specification may mean “one,” butit is also consistent with the meaning of “one or more” or “at leastone.” The term “about” means, in general, the stated value plus or minus5%. The use of the term “or” in the claims is used to mean “and/or”unless explicitly indicated to refer to alternatives only or thealternative are mutually exclusive, although the disclosure supports adefinition that refers to only alternatives and “and/or.”

The terms “comprise” (and any form of comprise, such as “comprises” and“comprising”), “have” (and any form of have, such as “has” and“having”), “include” (and any form of include, such as “includes” and“including”) and “contain” (and any form of contain, such as “contains”and “containing”) are open-ended linking verbs. As a result, a method ordevice that “comprises,” “has,” “includes” or “contains” one or moresteps or elements, possesses those one or more steps or elements, but isnot limited to possessing only those one or more elements. Likewise, astep of a method or an element of a device that “comprises,” “has,”“includes” or “contains” one or more features, possesses those one ormore features, but is not limited to possessing only those one or morefeatures. Furthermore, a device or structure that is configured in acertain way is configured in at least that way, but may also beconfigured in ways that are not listed.

In the foregoing Detailed Description, various features are groupedtogether in several embodiments for the purpose of streamlining thedisclosure. This method of disclosure is not to be interpreted asreflecting an intention that the disclosed embodiments require morefeatures than are expressly recited in each claim. Rather, as thefollowing claims reflect, inventive subject matter may lie in less thanall features of a single disclosed embodiment. Thus, the followingclaims are hereby incorporated into the Detailed Description, with eachclaim standing on its own as a separate embodiment.

Although the embodiments of the present disclosure and their advantageshave been described in detail, it should be understood that variouschanges, substitutions and alterations can be made herein withoutdeparting from the spirit and scope of the disclosure as defined by theappended claims. Moreover, the scope of the present disclosure is notintended to be limited to the particular embodiments of the process,machine, manufacture, composition of matter, means, methods and stepsdescribed herein. As one of ordinary skill in the art will readilyappreciate from the present disclosure, processes, machines,manufacture, compositions of matter, means, methods, or steps, presentlyexisting or later to be developed that perform substantially the samefunction or achieve substantially the same result as the correspondingembodiments described herein may be utilized according to the presentdisclosure. Accordingly, the appended claims are intended to includewithin their scope such processes, machines, manufacture, compositionsof matter, means, methods, or steps.

What is claimed is:
 1. An anterior tibia plate comprising: an elongatedfirst portion including a first plurality of apertures, said firstplurality of apertures being disposed to orient a respective bonefastener into a bone, and said first portion having a first thickness; asecond portion that widens outward with respect to said elongated firstportion, said second portion having a second plurality of apertures,said second plurality of apertures being disposed to orient a respectivebone fastener into said bone, and said second portion having a secondthickness; and a plurality of removable tabs, said removable tabsattached to said second portion along an outer edge of said secondportion.
 2. The anterior tibia plate of claim 1, wherein said removabletabs are configured to provide fixation points for said anterior tibiaplate.
 3. The anterior tibia plate of claim 1, wherein said fixationpoints include at least one aperture disposed to orient a bone fastenerinto said bone.
 4. The anterior tibia plate of claim 1, wherein saidsecond portion comprises a central opening following a contour of saidouter edge of said second portion.
 5. The anterior tibia plate of claim4 further comprising a middle bridge disposed within said centralopening.
 6. The anterior tibia plate of claim 5, wherein said middlebridge is configured to provide a fixation point for said anterior tibiaplate.
 7. The anterior tibia plate of claim 1, wherein said secondthickness is less than said first thickness.
 8. The anterior tibia plateof claim 7, wherein said first thickness tapers into said secondthickness.
 9. The anterior tibia plate of claim 1, wherein saidapertures in said first plurality of apertures and second plurality ofapertures are threaded apertures.
 10. The anterior tibia plate of claim1, wherein said bone is a tibia bone, and wherein said elongated firstportion and said second portion are configured to conform to an anteriorportion of said tibia bone.
 11. The anterior tibia plate of claim 1,wherein said bone is a tibia bone, and wherein said second portion ispreconfigured to conform to a distal portion of said tibia bone.